(Evanston, IL - November 15, 2004) Many women are concerned about whether
their bodies will "get back to normal" after childbirth and may wonder which
delivery mode is "best" - vaginal or cesarean. While Cesarean deliveries involve
major surgery and have greater potential for maternal complications, new research
has shed light on one benefit of cesarean delivery over vaginal birth. In an
internationally recognized, award-winning study, Roger Goldberg, MD, MPH, director
of Urogynecology Research at the Evanston Continence Center, has found the rate
of stress urinary incontinence (SUI) was three times higher in women after vaginal
childbirth compared to cesarean. In fact, a woman's mode of delivery impacts
her risk of SUI more profoundly than any other factor, including age, body mass
index, or the number of childbirths.

The study, entitled Delivery Mode is the Main Determinant of Stress Urinary
Incontinence After Childbirth: Analysis of 288 Identical Twins, won Dr.
Goldberg the top research award from the two largest professional groups in
the world that study continence issues - the International Continence Society
and the International Urogynecology Association. Their first joint meeting was
held August 23-27, 2004, in Paris. The organizations cited the study as a landmark
in women's health research for providing new insights into a controversial issue.

The study involved an extensive survey of 144 identical twin sister pairs (288
women) at the world's largest annual gathering of twins in Twinsburg, Ohio,
in order to determine the main environmental risk factors associated with stress
urinary incontinence. The average age of respondents was 47 years and 54 percent
of the women had symptoms of stress incontinence.

"Unlike previous studies," Goldberg says, "this allows us to finally conclude
that mode of delivery has a fundamental impact on a woman's risk of incontinence.
It is clear that a woman's decision between vaginal and cesarean birth may have
important physical repercussions." Despite the finding, he cautions, "Cesarean
delivery by choice remains a complex issue relating to many physical and psychological
factors, which should be carefully discussed between a woman and her doctor."
However, the Twin Sisters Study does provide remarkable new insight into the
effects of childbirth on a woman's body."

"This study of identical twin sisters is revolutionary because it provides
the strongest evidence yet on the relationship between a woman's obstetrical
choices and her risk of developing incontinence," says Peter K. Sand, MD, secretary/treasurer
of the International Urogynecology Association. "Previous studies have not been
able to determine whether stress urinary incontinence was caused by 'nature'
or 'nurture' (genetic or environmental factors), but the Twin Sisters Study
enables us to draw powerful conclusions because it controls for genetic risk
factors in order to understand environmental risk factors."